1. Medications that Can Lead to a Dysphagia Side-Effect - Swallow Study

Warning: This chart was created by , and it is intended to be used as a resource or guide for SpeechLanguage Pathologists and other healthcare professionals. This is not a complete list of all medications that could

cause dysphagia, dry mouth and/or central nervous system changes. This information should not be used as a substitute for consultation with the appropriate healthcare professionals (e.g., the patient's doctor & pharmacist).

1.

Medications that Can Lead to a Dysphagia Side-Effect

Neuromuscular Blocking Agents / Direct effect on striated muscle

Specific Drug Names:

Also Known As:

Common Uses:

Atracurium

Tracrium

Muscle relaxation

Cisatracurium

Nimbex

Muscle relaxation

Doxacurium

Nuromax

Long-acting muscle relaxation

Mivacurium

Mivacron

Short-acting muscle relaxation

Pancuronium

Pavulon

Muscle relaxation

Pipecuronium

Arduan

Muscle relaxation

Rocuronium

Zemuron

Muscle relaxation

Succinylcholine

Anectine

Muscle relaxation during surgery when using a ventilator; sometimes used during intubation

Tubocurarine

Tubarine

Muscle relaxation

Vecuronium

Norcuron

Muscle relaxation (generally given before anesthesia)

Antipsychotic / Major Tranquilizers / Neuroleptics

Examples of Typical/ Conventional:

Also Known As:

Common Uses:

Chloropromazine

Thorazine

Treat psychotic disorders including schizophrenia, manic-depression, or severe behavioral problems

Haloperidol

Haldol

Examples of Atypical/ Novel:

Clozapine Olanzapine

Also Known As:

Clozaril Zyprexa

Risperidone

Risperdal

Treat schizophrenia and Tourette's syndrome (*per should not be used for psychotic conditions related to dementia)

Common Uses:

Treat schizophrenia

Treat psychotic disorders including schizophrenia or bipolar disorder

Treat schizophrenia, bipolar disorder

Medications that can cause to Esophagitis / Esophageal Injury / GERD (con't)

Drug Classes:

Examples (brand names): Common Uses:

Bisphosphonate

Alendronate (Fosamax) Etidronate Ibandronate (Boniva)

Postmenopausal osteoporosis, irregular bone growth

Antibiotics Akhtar (2003)

Doxycycline Tetracycline Clinamycin Penicillin Erythromycin Ciproxfloxacin Lincomycin

Treat infections

Bronchodilator

Theophylline (Theo-24, Theo-Dur, Norphyl, etc)

Fluticasone/Salmeterol (Advair)

Bronchodilator (When using inhalers, rinse mouth with water and spit out water to prevent thrush/sores)

Medications that can cause to Esophagitis / Esophageal Injury / GERD (con't)

Non-Steroidal AntiInfammatory (NSAIDS)

Ibuprofen (Advil) Aspirin Naproxen (Aleve) Indomethacin (Indocin)

Analgesic, Antiinflammatory

Steroid (corticosteroid)

Methylprednisolone (Medrol) Prednisone

Anti-inflammatory, immune suppressant

Anticholinergics

Emepronium Bromide

Treats overactive bladder (can cause esophageal ulcer)

Quinidine

Quinine or Quinidex

Treats malaria, but also antiarrhythmias.

Alprenolol Chloride/ Antihypertensive

Aptine

Minerals and others

Potassium Chloride Ferrous Sulfate or succinate Ascorbic acid

Factors that increase risk for the medication to cause esophageal injury, stricture and/or ulceration: Stoschus & Allescher (1993) Akhtar (2003)

? Taken at bedtime

? Geriatrics at increased

? Taken without enough risk

fluid

? Enlargement of Left

? Taken in supine

Atrium compressing

position or in bed

esophagus

? Large pill size

? Thoracic surgery

? Hx of cirrhosis & portal ? Hx of Esophageal

hypertension

motility disorders &

strictures

Medications that can cause to Esophagitis / Esophageal Injury / GERD (con't)

Drugs that can cause gastroesophageal reflux (listed below):

Drugs that can decrease lower esophageal sphincter pressure (listed below):

Other items that can decrease lower esophageal sphincter pressure (below):

Bronchodilators

Antiangina meds (Nitroglycerin, Isosorbide mononitrate)

Atropine (Atropar)

Dopamine

Butylscopolamine spasmolytic, anticholinergic (Buscopan)

Alcohol

Fatty, fried foods

Hormones: Cholecycstokinin (stimulates digestion of fat and protein) Glucagon Progesterone

Calcium Channel blocker (Nifedinpine, Diltiazem)

Anxiolytic (Alprazolam)

Theophylline

Nitrates Calcium Antagonists

Chocolate Mint

2. Medications that Can Lead to a Xerostomia / Dry Mouth Side-Effect:

Anticholinergic with Antimuscarinic Effects & Antispasmodics (Inhibiting parasympathetic nervous system)

Specific Drug Names:

Also Known As:

Common Uses:

Atropine

Atropar

Relief from gastrointestinal spasms; antidiarrheal; treating colitis; spastic bladder; diverticulitis

Benztropine mesylate

Cogentin

Treating Parkinson's Disease symptoms, including muscle spasms, stiffness, tremors, drooling

Hyoscyamine

Cytospaz

Treating stomach, bowel and bladder spasms

Anticholinergics (con't): Ipratropium

Also known as: Atrovent

Tiotropium

Spiriva

Scopolamine (Antiemetic) Transderm-Scop

Pirenzepine

Gastrozepin

Tolterodine Hyoscyamine

Detrol Levsin

Diphenhydramine

Benadryl

Oxybutynin Emepronium Bromide

Ditropan, Driptane Emepronium Bromide

Common Uses:

Relaxes muscles in airways Increases airflow to lungs

Treats asthma and COPD

Relieves nausea, vomiting and dizziness. Used to decrease secretion of fluids (i.e., saliva).

Treats peptic ulcers, reduces gastric acid secretions, reduces muscle spasm.

Urinary antispasmodic for overactive bladder

Reduces muscle spasms in digestive system, and can be used to dry and reduces secretions

Treats allergy, hay fever, cold symptoms, itching, rashes. Can be used to treat insomnia.

Treats overactive bladder

Treats overactive bladder

More Medications with Potential Xerostomia Side-Effects

Drug Classes:

Examples (brand names): Common Uses:

Angiotensin-converting enzyme (ACE) inhibitors

Lisinopril (Zestril, Prinivil, Tensopril, Hipril) Captopril (Capoten), Enalapril (Vasotec, Renitec)

Block the angiotensin converting enzyme to reduce blood pressure. Serious side-effect: angioedema (swelling) - tongue?

Antihypertensives

Guanfacine (Tenex) Clonidine (Catapres) Terazosin (Hytrin)

Treat high blood pressure

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